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Health and Wellbeing Board
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19 January 2022
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Report of the
Director of Public Health
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JSNA – Annual
Update
Summary
1.
This report provides members of the
Health and Wellbeing Board with an update on the Joint Strategic
Needs Assessment (JSNA), including work undertaken in the last
year, the refreshed JSNA working group and planned work for the
coming year.
Recommendations
2.
Members of the Health and Wellbeing
Board are asked:
i.
to note the content of this report
and comment on how the JSNA and work of the Population Health Hub
can shape the next York Health and Wellbeing Strategy.
ii.
to comment on the mechanism for
keeping the board informed about JSNA progress
iii.
to comment on the use of the JSNA
within their own organisations, and suggest how this use could be
increased.
Background
Recent Developments in York’s
JSNA
3.
Health needs assessments (HNA) are a
key ‘tool’ within the public health field and
specialism, used internationally as a coherent and robust tool to
understand the needs and inequalities of populations and to
underpin planning and decision-making. Whilst a variety of
approaches can be beneficial, most HNAs incorporate elements of
epidemiological assessment (e.g. trends in disease prevalence,
service activity), comparative assessment (evidence and data from
other areas) and stakeholder/patient assessment (e.g. focus groups,
surveys).
4.
Since 2013 it has been a statutory
duty of CCGs and Local Authorities, through the Health and
Wellbeing Board, to produce a Joint Strategic Needs Assessment,
which usually consists of an overarching narrative summary on the
needs of a population and deeper pieces of work on specific groups
within that community. In York, the JSNA steering group has
overseen the production of the overarching narrative
alongside
‘topic-specific’ needs assessments, which in recent
years have covered a broad range of areas themed by the four key
areas of the Health and Wellbeing Strategy:
Starting and Growing
Well
Sexual Health Needs Assessment -
2018
Starting and Growing Well:
Inequality Report 2018
Children and Young People Oral
Health Needs Assessment – 2019
SEND Needs Assessment 0-16
2020
SEND Needs Assessment 16-25
2022
Living Well
Student Health Needs Assessment -
2017
All Age Autism Needs
Assessment - 2016
Learning Disability Needs
Assessment 2018
Aging Well
Healthy ageing in older adults,
inequalities report - 2019
Self-funders needs assessment -
2019 summary report
The Older People's Survey -
2017
Frail Elderly Needs Assessment -
2015
Eye Health Needs Assessment –
2015
Mental Health
Mental health report into equity of
access to services 2018
Self Harm Needs Assessment -
2016
Alcohol Needs Assessment -
2016
Suicide Audit - 2016
Mental Health Needs Assessment
– 2015
Bereavement Needs Assessment
2021
Other
Rapid Review into the Impact of
Covid-19 - 2020
Indices of multiple deprivation
15/16 (published 2019)
Homeless Health Needs Assessment -
2018
Pharmaceutical Needs Assessment
(2018-2021)
Poverty Needs Assessment -
2015
Pharmaceutical Needs Assessment
– 2014
5.
Work on the JSNA is closely aligned
to work on a population health management approach to health and
care services. Because of this, the JSNA working group now sits as
part of the newly formed Population Health Hub (PHH) steering
group. The Population Health Hub is a multi-agency network
comprising of representatives of City of York Council, Vale of York
CCG, York and Scarborough Teaching Hospital NHS Trust, Tees, Esk
and Wear Valleys NHS Trust, North Yorkshire Police, Healthwatch
York, with other organisations welcomed to join.
6.
The PHH steering group’s
purpose is to ensure that the
development and delivery of population health management (PHM)
programmes and the JSNA is well managed and embedded into local
decision-making. Further information on the PHH steering
group’s purpose, responsibilities and governance can be found
in the Terms of Reference (Annex A).
7.
Population Health Management (PHM)
improves population health by data driven planning and delivery of
services to achieve maximum impact. It includes segmentation,
stratification and modelling to identify local ‘at
risk’ population groups. Following this identification of
population groups, it is then about designing and targeting
interventions to prevent ill-health and to improve care and support
for people with ongoing health conditions.
8.
Within York, the PHH has three main
functions:
i.
Enabling - Supporting the York
health and care system to use
population health data, and PHM as a tool
ii.
Analysing - Improving the JSNA,
making it useful and used
iii.
Doing - Leading tangible PHM
projects which show the benefit of this approach
9.
The JSNA is an integral part of the
PHH and it is hoped by combing the existing membership of the JSNA
working group into the newly formed PHH steering group, the JSNA
can become an integral part of future service planning,
commissioning and improvement.
10.
Alongside the overarching strategic
needs assessment, topic specific needs assessments (sometimes
referred to as deep dives) are also undertaken. In an effort to
simplify the process for requesting a topic specific needs
assessment, a simplified request form has been developed (Annex B).
This form is accessible through the JSNA website or on request from
the public health team. Requests are considered at each PHH
steering group and if agreed to be undertaken, the assessment is
put on the JSNA forward plan.
JSNA outputs in 2021
11.
Alongside the revision of the JSNA
working group into the PHH steering group, there have also been two
topic specific needs assessments undertaken. The number of
assessments produced is lower than in previous years due to the
impact of COVID, which has put pressure on public health capacity
to undertake assessments and has also resulted in less requests.
All topic specific needs assessments are published on the JSNA
website (www.healthyork.org).
12.
Topic specific needs assessments are
in-depth pieces of work, usually taking several months to complete.
They require a collaborative approach across the local authority
and partner organisations, to collate the relevant data, gain
insight and feedback from professionals and service users and then
produce the assessment with recommendations. During 2021 reports
were produced on:
·
Bereavement – requested by the
Mental Health Partnership. This found that overall there are a good
range of bereavement support services in York, supplemented by a
very broad range of national bereavement support organisations.
None of the services identified a significant increase in demand
due to covid, but all identified that the lockdown measures had
caused them to need to deliver support in a different way. The
report was presented to the Mental Health Partnership in September
2021.
·
SEND Phase 1 – produced in
response to the 2019 Ofsted and CQC inspection. This report looked
at many areas across early years and young people (aged 0 –
16) with SEND. The report produced a large number of
recommendations for the SEND improvement board to take forwards. A
second phase is ongoing, with a focus on those young people aged
17-25.
Planned outputs for 2022
13.
The initial priority for 2022 is to
ensure the overarching JSNA is up to date with the latest data,
data sources and is identifying the correct areas where York is
doing well, where York needs to improve and where there are areas
of inequality. The data is presented on the healthyork.org website,
where it can be viewed online or downloaded into document format.
The data will continue to be presented under the following
headings: starting and growing well, living and working well,
ageing well, mental health and place. The refresh will also
incorporate data presented in graphical and tabular formats,
alongside narrative.
14.
It is anticipated that board members
will use the updated JSNA to inform the upcoming refresh of the
Joint Health & Wellbeing Strategy. Information contained within
the JSNA will help the board to identify areas of priority need
within the city.
15.
The Pharmaceutical Needs Assessment
(PNA) is a statutory duty of the Health and Wellbeing Board. The
purpose of the PNA is to consider the current and future need for
pharmaceutical services in an area, and to describe to what extent
the current pharmaceutical services meet that need. The current PNA
covers the period 2018 – 2021, with a renewed assessment due
to be published in March 2021. However due to the COVID pandemic,
this deadline was extended to March 2022 and then again to October
2022.
16.
As with the previous PNA, officers
from City of York Council Public Health are working in partnership
with colleagues from North Yorkshire County Council. Two separate
assessments will be produced for each local authority. It is
anticipated that a draft PNA will be available for consultation by
board members and members of the public in July 2022. The final
report will be presented to the board in September 2022 for sign
off, prior to publication in October 2022.
17.
Two topic specific needs assessments
are currently scheduled to be undertaken in 2022, SEND phase 2 (as
discussed above) and Early Years. The Early Years needs assessment
is part of a wider focus on Children and Young people across all
ages, with a survey being sent to school children of both primary
and secondary age. The survey asks questions around a range of
health and wellbeing topics, with results expected
shortly.
18.
The Early Years needs assessment
will have an age range focus from pre-conception through to 3 years
old. The needs assessment will consider a breadth of topic areas,
such as demographics, physical health, mental health, education,
housing status and service utilisation. The focus will be how these
topic areas influence two focus outcomes, which have been
identified as priority areas at EYIB (Early Years Improvement
Board); Speech and language communication and Social, emotional and
mental health.
19.
Additionally, it is anticipated that
further topic specific needs assessments will arise, either through
requests from officers within the local authority and/or external
organisations, or in response to local requirements for reactive
needs assessments.
20.
In order to increase the reach of
the JSNA and its utilisation, a regular newsletter is planned with
a target audience of interested professionals and members of the
public. A “sounding board” is also planned to be
delivered, where updates on the JSNA topics will discussed and
presented to members of the public. This will also give the
opportunity for discussion on recommendations identified and enable
suggestions for future topic specific needs assessments.
21.
It is proposed that progress on the
Population Health Hub and JSAN is reported annually to the Health
and Wellbeing Board
Contact Details
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Author:
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Chief Officer Responsible for the
report:
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Author’s
name: Phil Truby
Title: Public Health Specialist
Practitioner Advanced
T: 01904 553959
E: philip.truby@york.gov.uk
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Chief
Officer’s name: Peter Roderick
Title: Consultant in Public
Health
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Report Approved
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Date
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06.01.2022
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Wards
Affected: [List
wards or tick box to indicate all]
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All
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For further information please contact the
author of the report
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List of Abbreviations Used in
this Report
CCG – Clinical
Commissioning Group
CQC – Care Quality
Commission
EYIB – Early Years
Improvement Board
JSNA – Joint Strategic
Needs Assessment
NHS – National Health
Service
PHM – Population Health
Management
PHH – Population Health
Hub
PNA – Pharmaceutical
Needs Assessment
SEND – Special education
need and disability
